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New Drugs for Rheumatoid Arthritis Pass Peer Review
New weapons in the fight against rheumatoid arthritis were presented at the peer-reviewed American College of Rheumatology National Scientific Meeting Nov. 8-12 in San Diego, Calif.
Rheumatoid arthritis is a debilitating disease that affects 1 percent of the adult population. It causes pain, stiffness and swelling in many joints and, unlike osteoarthritis, often strikes at an early age. For the first time in nearly a decade, several new drugs are becoming available to treat this disease.
Anti-TNF drugs work by neutralizing a natural compound thought to be one cause of joint destruction. One study followed RA patients on a combination of methotrexate (the standard of RA treatment for years) and either etanercept (a soluble TNF-alpha receptor) or placebo through 24 weeks. Responses to etanercept plus methotrexate were rapid, sustained, and superior to methotrexate alone. Mild injection site reactions were the only significant side effects. Another study followed rheumatoid arthritis patients on methotrexate alone or in combination with infliximab (a monoclonal antibody to TNF-alpha) through 40 weeks of treatment. The benefit of infliximab was evident within a week and sustained throughout the study.
Leflunomide is a reversible enzyme inhibitor recently approved by the FDA for the treatment of rheumatoid arthritis. It inhibits at least one enzyme in the immune system and thus interferes with the RA disease process. A 12-month study compared leflunomide to methotrexate and to placebo. Leflunomide was shown to be comparable to methotrexate in both efficacy and safety. In clinical trials, both leflunomide and methotrexate were shown to slow the progression of rheumatoid arthritis.
Mycophenolate mofetil is an immunomodulator already approved by the FDA for organ transplant recipients. Researchers conducted a three-year study of RA patients on this drug or on placebo. The first nine months showed significant difference between the placebo and mycophenolate mofetil groups. The second and third years of the study demonstrated that GI problems such as diarrhea were the most common side effects of the drug.
"This is an exciting time for rheumatology," said Bevra Hahn, MD, president of the ACR. "After years of research, we now have multiple new options for our patients."
All data presented at this meeting were reviewed by a panel of rheumatologic experts. The ACR National Scientific Meeting is the largest and most prestigious rheumatology meeting in the world. The ACR does not endorse any commercial products.
The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal diseases. For more information on this meeting, see http://www.rheumatology.org/educ/nm98/nm98.html.
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